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Lichtman MA, Sham R. Acquired elliptocytosis in chronic myeloid neoplasms: An enigmatic relationship to acquired red cell membrane protein and genetic abnormalities. Blood Cells Mol Dis 2023; 103:102778. [PMID: 37379758 DOI: 10.1016/j.bcmd.2023.102778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
Nineteen reports of 41 cases of acquired red cell elliptocytosis associated with a chronic myeloid neoplasm are described. Although the majority of cases have an abnormality of the long arm of chromosome 20, del(q20), several cases do not. Moreover, in one case a specific qualitative abnormality of red cell protein band 4.1(4.1R) was reported; however, several subsequent cases could find no abnormality of a red cell membrane protein or found a different abnormality, usually quantitative. Thus, this striking red cell phenotypic feature, acquired elliptocytosis, seen in myelodysplastic syndrome and other chronic myeloproliferative diseases, closely simulating the red cell phenotype of hereditary elliptocytosis, has an unexplained genetic basis, presumably as the result of an acquired mutation(s) in some chronic myeloid neoplasms.
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Affiliation(s)
- Marshall A Lichtman
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Ave, Box 706, Rochester, NY 14642-0001, USA.
| | - Ronald Sham
- Division of Hematology and Oncology, Rochester General Hospital, Rochester Regional Health, Rochester, NY 14621, USA
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3
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Lakhwani S, Pardina-Echevarría M, Arcas-Vega R, Díaz-Sánchez OR, Hernández-García MT, Raya JM. Relevance of early diagnosis in polycythemia vera and essential thrombocythemia: A single center's experience. Rev Clin Esp 2021; 222:169-173. [PMID: 34657827 DOI: 10.1016/j.rceng.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 07/01/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This work aims to describe the proportion of patients with polycythemia vera (PV) or essential thrombocythemia (ET) and thrombosis prior to the diagnosis who had erythrocytosis or thrombocytosis prior to the thrombosis. PATIENTS AND METHODS This is a retrospective review of 63 patients with PV and 130 with ET. RESULTS In regard to PV, we found prior erythrocytosis in 7 (11.1%) of the 17 cases (27%) with thrombosis prior to diagnosis. In ET, we found prior thrombocytosis in 10 (7.7%) of the 25 cases (19.2%) with thrombosis prior to diagnosis. The median time between the laboratory finding and thrombosis was 8.2 months and 11.8 months for PV and TE, respectively. In both entities, patients with thrombosis prior to diagnosis had significantly lower survival. CONCLUSION A significant proportion of patients with thrombosis prior to the diagnosis of PV and ET present with erythrocytosis or thrombocytosis prior to the episode of thrombosis. This could allow for anticipating diagnosis and treatment.
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Affiliation(s)
- S Lakhwani
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain.
| | - M Pardina-Echevarría
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - R Arcas-Vega
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - O R Díaz-Sánchez
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - M T Hernández-García
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - J M Raya
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
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Venton G, Turcanu M, Colle J, Thuny F, Chebrek S, Farnault L, Mercier C, Ivanov V, Fanciullino R, Suchon P, Jarrot PA, Aissi K, Roche P, Cautela J, Arcani R, Costello R. Pulmonary hypertension in patients with myeloproliferative neoplasms: A large cohort of 183 patients. Eur J Intern Med 2019; 68:71-75. [PMID: 31421946 DOI: 10.1016/j.ejim.2019.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/05/2019] [Accepted: 08/07/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND Chronic myeloproliferative neoplasms (MPN) are recognized as a cause of pulmonary hypertension (pH). We ought to describe the prevalence and characteristics of PH in a cohort of MPN who were screened using transthoracic echocardiography (TTE). METHODS One hundred eighty-three newly diagnosed consecutive MPN patients were prospectively evaluated using TTE to detect PH. RESULTS Two patients were diagnosed with chronic eosinophilic leukemia, two patients had post-essential thrombocythemia (ET) myelofibrosis (MF), two patients had post-polycythemia vera (PV) MF, 11 patients had primary myelofibrosis (PMF), 28 patients had chronic myeloid leukemia (CML), 51 patients had PV, and 87 patients had ET. TTE was used to determine PH, and PH was suspected in 16 of 183 patients as follows: four with PV, seven with ET, two with PMF, and three with CML. Two patients with ET were excluded because of global cardiac failure. Three patients underwent right heart catheterization to confirm PH. The 14 (7.7%) patients with PH had no cardiac or lung disease that directly involved MPN in PH development. CONCLUSION In this large cohort of 183 MPN patients, TTE was used to diagnose PH, and 14 patients (7.7%) developed PH. This prevalence was lower than expected based on previously reported data, but it remains higher than in the general population.
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Affiliation(s)
- Geoffroy Venton
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, France; Aix-Marseille University, INSERM, UMR1090 TAGC, Marseille F_13288, France
| | - Mihai Turcanu
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, France; General Medicine Department, Aix-Marseille University, France
| | - Julien Colle
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, France; Aix-Marseille University, INSERM, UMR1090 TAGC, Marseille F_13288, France
| | - Franck Thuny
- Aix-Marseille University, Assistance Publique - Hopitaux de Marseille, Mediterranean University Cardio-Oncology Center, Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France; Aix-Marseille University, Inserm, Inra, Centre for Cardio-Vascular and Nutrition research (C2VN), Marseille, France
| | - Safia Chebrek
- Hematology Department, Hospital of Avignon, Marseille, France
| | - Laure Farnault
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, France
| | - Cédric Mercier
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, France; UMR-911 INSERM, Toxicokinetics and Pharmacokinetics Laboratory, Pharmacological Faculty, Marseille, France
| | - Vadim Ivanov
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, France
| | - Raphaëlle Fanciullino
- SMARTc Unit, Pharmacokinetics Laboratory, UMR_911 CRO2 AMU, Marseille, France; Pharmacy Unit, La Conception, University Hospital of Marseille, APHM, Marseille, France
| | - Pierre Suchon
- Hematology Laboratory, La Timone, University Hospital of Marseille, France; UMR 1062 NORT, INSERM, Marseille, France
| | - Pierre-André Jarrot
- Internal Medicine and Clinic Immunology Department, La Conception, University Hospital of Marseille, France; Center for Cardiovascular and Nutrition Research, INRA 1260, INSERM _S1263, Aix-Marseille University, France
| | - Karim Aissi
- Internal Medicine Department, North Hospital, University Hospital of Marseille, France
| | - Pauline Roche
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, France
| | - Jennifer Cautela
- Aix-Marseille University, Assistance Publique - Hopitaux de Marseille, Mediterranean University Cardio-Oncology Center, Unit of Heart Failure and Valvular Heart Diseases, Department of Cardiology, Hôpital Nord, Marseille, France; Aix-Marseille University, Inserm, Inra, Centre for Cardio-Vascular and Nutrition research (C2VN), Marseille, France
| | - Robin Arcani
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, France.
| | - Regis Costello
- Hematology and Cellular Therapy Department, La Conception, University Hospital of Marseille, France; Aix-Marseille University, INSERM, UMR1090 TAGC, Marseille F_13288, France
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Singh K, Sazawal S, Chhikara S, Mahapatra M, Saxena R. Association of JAK2V617F mutation with thrombosis in Indian patients with Philadelphia negative chronic myeloproliferative neoplasms. INDIAN J PATHOL MICR 2018; 61:371-374. [PMID: 30004057 DOI: 10.4103/ijpm.ijpm_781_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background : It is still a matter of debate regarding the association of JAK2V617F mutation with thrombosis in BCR-ABL negative CMPN patients. The role of JAK2V617F mutation in increasing the thrombotic risk in CMPNs is yet unequivocal. Aims : To clarify the contribution of JAK2V617F mutation in thrombosis in CMPN patients. Settings and Design This retrospective study was done to evaluate role of JAK2V617F mutation in thrombosis in CMPNs. Materials and Methods 65 CMPN patients (PV, ET and PMF) were analyzed for JAK2V617F mutation using ARMS-PCR and detailed history of thrombosis was recorded in these patients. Statistical Analysis P values were 2 tailed, and statistical significance was set at P < 0.05. Results : 46/65 were males and 19/65 were females [M: F: 2.4:1] with median age 46 years [range, 14-80 years]. Patients had median Hb 15.6 g/dl [range, 5.1-20.3], median TLC 10.7 × 109/l [range 2.4-216] and platelet count 360 × 109/l [range, 20-1859]. 32 were JAK2V617F positive and 33 were negative for this mutation. On comparing the prevalence of thrombosis in JAK2V617F positive patients with JAK2V617F negative patients, we observed that 20/32 (62.5%) JAK2V617F positive patients had thrombosis as compared to 16/33 (48%) in JAK2V617F negative patients (P = 0.04). We observed significant association of JAK2V617F mutation with thrombosis, however no association of this mutation with thrombosis was observed among the JAK2V617F negative patients. Conclusion Our study suggests that JAK2V617F mutation may increase the risk of thrombosis in CMPNs. This finding could lead to risk stratification, setting up the treatment strategy in CMPNs.
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Affiliation(s)
- Kanwaljeet Singh
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Sudha Sazawal
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Sunita Chhikara
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Manoranjan Mahapatra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Saxena
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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Farmer S, Shanbhogue VV, Hansen S, Stahlberg CI, Vestergaard H, Hermann AP, Frederiksen H. Bone mineral density and microarchitecture in patients with essential thrombocythemia and polycythemia vera. Osteoporos Int 2017; 28:677-685. [PMID: 27734102 DOI: 10.1007/s00198-016-3788-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/22/2016] [Indexed: 02/07/2023]
Abstract
UNLABELLED In this cross-sectional study of 45 patients with myeloproliferative neoplasms, we found no evidence of secondary osteoporosis. INTRODUCTION Patients with essential thrombocythemia (ET) and polycythaemia vera (PV) are at increased risk of fractures but the underlying mechanisms have not been settled. We conducted a study to assess bone mineral density, microarchitecture, estimated bone strength and global bone turnover in 45 patients with ET or PV. METHODS Patients were evaluated in a cross-sectional study with dual energy X-ray absorptiometry (DXA) at the hip and spine; high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and distal tibia; and biochemical markers of bone turnover including pro-collagen type 1 N-terminal pro-peptide, osteocalcin, C-terminal cross-linking telopeptide of type 1 collagen and bone-specific alkaline phosphatase. Also, 45 healthy comparisons, matched on age, height and weight with each patient were included as control subjects. RESULTS Patients and comparisons had almost identical BMDs: 0.96 (IQR: 0.85-1.07) g/cm2 and 0.96 g/cm2 (IQR: 0.86-1.05 g/cm2), respectively. As well all microarchitecture and estimated bone strength measures were highly similar in the two groups. Levels of bone turnover markers were within reference values in patients. CONCLUSION These results reveal no evidence of secondary osteoporosis among patients with ET or PV. The mechanism behind the increased fracture risk in ET or PV patients remains unknown.
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Affiliation(s)
- S Farmer
- Department of Haematology, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense, Denmark.
| | - V V Shanbhogue
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - S Hansen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - C I Stahlberg
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - H Vestergaard
- Department of Haematology, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense, Denmark
| | - A P Hermann
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - H Frederiksen
- Department of Haematology, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense, Denmark
- Department of Clinical Epidemiology, Aarhus University Hospital, Odense, Denmark
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Uyanik MS, Baysal M, Pamuk GE, Maden M, Akker M, Umit EG, Demir M, Aydogdu E. Is JAK2V617F Mutation the Only Factor for Thrombosis in Philadelphia-Negative Chronic Myeloproliferative Neoplasms? Indian J Hematol Blood Transfus 2016; 32:262-7. [PMID: 27429517 DOI: 10.1007/s12288-015-0578-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 08/05/2015] [Indexed: 01/14/2023] Open
Abstract
The most common genetic disorder in Philadelphia negative chronic myeloproliferative neoplasms is the JAK2-V617F mutation. In the present study, we aimed to determine risk factors for thrombosis in patients with essential thrombocytosis and polycythemia vera. We screened the medical records of 101 patients. Risk factors which may predict thrombosis were recorded. Venous thrombosis (VT) before diagnosis was significantly higher in JAK2 positive patients. VT after diagnosis was similar in JAK2 positive and negative groups, and was significantly higher in elderly patients. Treatment places importance on the JAK2 mutation under unmodifiable cardiovascular risk factors such as advanced age after diagnosis.
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